Catheter ablation of right atrial ganglionated plexi to treat cardioinhibitory neurocardiogenic syncope: a long-term follow-up prospective study

Calò, Leonardo; Rebecchi, Marco; Sette, Antonella; Sciarra, Luigi; Borrelli, Alessio; Scarà, Antonio; Grieco, Domenico; Politano, Alessandro; Sgueglia, Marianna; Luca, Lucia De; Martino, Annamaria; Panattoni, Germana; Golia, Paolo; Turrisi, Oronzo Valerio; Knowles, Margaret A.; Strano, Stefano; Ruvo, Ermenegildo De

doi:10.1007/s10840-020-00840-9

Cited by 39 publications

(31 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Theoretically, neuromodulation of the intrinsic cardiac ANS works by preventing the parasympathetic efferent arm of the reflex arc in cardioinhibitory VVS and in mixed VVS types with a predominant cardioinhibitory response. The clinical efficiency of catheter based neuromodulation in patients with VVS has been reported by several groups (43)(44)(45)(46)(47)(48)(49), with freedom from syncope of between 80% and 100%.…”

Section: Theoretical Background Of Intrinsic Cardiac Autonomic Nervoumentioning

confidence: 87%

“…This strategy can be used in 2 different ways: adjunctive to electrogram analysis or HFS (44) or both; or as a true stand-alone strategy, via isolated right atrial or left atrial approaches (48,62). Sun et al (48) compared HFS-guided and empirically defined ablation approaches in 57 VVS cases. No statistical differences were found between HFS-guided and anatomical-guided ablation groups in either freedom from syncope or recurrent prodromes.…”

Section: Empirical Anatomic Ablationmentioning

confidence: 99%

See 1 more Smart Citation

Intrinsic Cardiac Autonomic Nervous System: what do clinical electrophysiologists need to know about the ‘heart brain’?

Aksu

Gopinathannair

Gupta

et al. 2021

Preprint

View full text Add to dashboard Cite

It is increasingly recognized that the autonomic nervous system (ANS) is a major contributor in many cardiac arrhythmias. Cardiac ANS can be divided into extrinsic and intrinsic parts according to the course of nerve fibers and localization of ganglia and neuron bodies. Although the role of extrinsic part has historically gained more attention, the intrinsic cardiac ANS may affect cardiac function independently as well as influence the effects of the extrinsic nerves. Catheter based modulation of the intrinsic cardiac ANS is emerging as a novel therapy for management of patients with brady and tachy arrhythmias resulting from hyperactive vagal activation. However, distribution of intrinsic cardiac nerve plexus in the human heart and the functional properties of intrinsic cardiac neural elements remain insufficiently understood. The present review aims to bring the clinical and anatomical elements of the ICANS together, by reviewing neuroanatomical terminologies and physiological functions, in order to guide the clinical electrophysiologist in the catheter lab, and to serve as a reference for further research.

show abstract

Section: Theoretical Background Of Intrinsic Cardiac Autonomic Nervoumentioning

confidence: 87%

Section: Empirical Anatomic Ablationmentioning

confidence: 99%

Intrinsic Cardiac Autonomic Nervous System: what do clinical electrophysiologists need to know about the ‘heart brain’?

Aksu

Gopinathannair

Gupta

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Theoretically, neuromodulation of the intrinsic cardiac ANS works by preventing the parasympathetic efferent arm of the reflex arc in cardioinhibitory VVS and in mixed VVS types with a predominant cardioinhibitory response. The clinical efficiency of catheter‐based neuromodulation in patients with VVS has been reported by several groups, 39,43,50–54 with freedom from syncope of between 80% and 100%.…”

Section: Introductionmentioning

confidence: 88%

Intrinsic cardiac autonomic nervous system: What do clinical electrophysiologists need to know about the “heart brain”?

Aksu

Gopinathannair

Gupta

et al. 2021

Cardiovasc electrophysiol

View full text Add to dashboard Cite

It is increasingly recognized that the autonomic nervous system (ANS) is a major contributor in many cardiac arrhythmias. Cardiac ANS can be divided into extrinsic and intrinsic parts according to the course of nerve fibers and localization of ganglia and neuron bodies. Although the role of the extrinsic part has historically gained more attention, the intrinsic cardiac ANS may affect cardiac function independently as well as influence the effects of the extrinsic nerves. Catheter‐based modulation of the intrinsic cardiac ANS is emerging as a novel therapy for the management of patients with brady and tachyarrhythmias resulting from hyperactive vagal activation. However, the distribution of intrinsic cardiac nerve plexus in the human heart and the functional properties of intrinsic cardiac neural elements remain insufficiently understood. The present review aims to bring the clinical and anatomical elements of the immune effector cell‐associated neurotoxicity together, by reviewing neuroanatomical terminologies and physiological functions, to guide the clinical electrophysiologist in the catheter lab and to serve as a reference for further research.

show abstract

“…The LAFE pattern could be caused by atrial fibrosis as observed in mathematical simulations of atrial tissue with fibrotic characteristics. Finally, on the basis of these consideration, we could image in the present 69,70 and in the future scenario of ANS cardiac denervation an ablation procedure guided by softwares which it will be possible to identify fragmented signal indicative of the presence of nervous tissue in the context of a healthy myocardium (Figure 4).…”

Section: Ganglionated Plexi Ablation For Atrial Fibrillationmentioning

confidence: 99%

Atrial fibrillation and autonomic nervous system: A translational approach to guide therapeutic goals

Rebecchi

Panattoni

Bressi

et al. 2021

Journal of Arrhythmia

Self Cite

View full text Add to dashboard Cite

The autonomic nervous system (ANS) is known to play an important role in the genesis and maintenance of atrial fibrillation (AF). Biomolecular and genetic mechanisms, anatomical knowledges with recent diagnostic techniques acquisitions, both invasive and non‐invasive, have enabled greater therapeutic goals in patients affected by AF related to ANS imbalance. Catheter ablation of ganglionated plexi (GP) in the left and right atrium has been proposed in varied clinical conditions. Moreover interesting results arise from renal sympathetic denervation and vagal nerve stimulation. Despite all this, in the scenario of ANS modulation translational strategies we necessary must consider the treatment or correction of dynamic factors such as obesity, obstructive sleep apnea, lifestyle, food, and stress. Finally, new antiarrhythmic drugs, gene therapy and “ablatogenomic” could be represent exciting future therapeutic perspectives.

show abstract

Catheter ablation of right atrial ganglionated plexi to treat cardioinhibitory neurocardiogenic syncope: a long-term follow-up prospective study

Cited by 39 publications

References 34 publications

Intrinsic Cardiac Autonomic Nervous System: what do clinical electrophysiologists need to know about the ‘heart brain’?

Intrinsic Cardiac Autonomic Nervous System: what do clinical electrophysiologists need to know about the ‘heart brain’?

Intrinsic cardiac autonomic nervous system: What do clinical electrophysiologists need to know about the “heart brain”?

Atrial fibrillation and autonomic nervous system: A translational approach to guide therapeutic goals

Contact Info

Product

Resources

About